Immediate and Long-Term Outcomes of Reperfusion Therapy in Patients With Cancer
- 주제(키워드) ischemic stroke , neoplasms , registries , reperfusion , thrombectomy
- 주제(기타) Clinical Neurology
- 주제(기타) Peripheral Vascular Disease
- 설명문(일반) [Yoo, Joonsang; Kim, Young Dae; Park, Hyungjong; Heo, Joonnyung; Kim, Minyoung; Choi, Jin Kyo; Hong, Jeong-Ho; Heo, Ji Hoe; Nam, Hyo Suk] Yonsei Univ, Coll Med, Dept Neurol, 50-1 Yonsei Ro, Seoul 03722, South Korea; [Yoo, Joonsang; Kim, Jinkwon] Yonsei Univ, Coll Med, Dept Neurol, Yongin Severance Hosp, Seoul, South Korea; [Kim, Byung Moon; Kim, Dong Joon] Yonsei Univ, Coll Med, Dept Radiol, Seoul, South Korea; [Kim, Hyeon Chang] Yonsei Univ, Coll Med, Dept Prevent Med, Seoul, South Korea; [Lee, Kyung-Yul; Jung, Yo Han] Yonsei Univ, Coll Med, Dept Neurol, Gangnam Severance Hosp,Severance Inst Vasc & Meta, Seoul, South Korea; [Lee, Hye Sun] Yonsei Univ, Coll Med, Biostat Collaborat Unit, Dept Res Affairs, Seoul, South Korea; [Park, Hyungjong; Sohn, Sung-Il; Hong, Jeong-Ho] Keimyung Univ, Sch Med, Dept Neurol, Brain Res Inst, Daegu, South Korea; [Bang, Oh Young; Seo, Woo-Keun; Chung, Jong-Won] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Neurol, Seoul, South Korea; [Han, Euna] Yonsei Univ, Yonsei Inst Pharmaceut Res, Coll Pharm, Incheon, South Korea; [Shin, Dong Hoon] Gachon Univ, Dept Neurol, Gil Med Ctr, Incheon, South Korea; [Choi, Hye-Yeon] Kyung Hee Univ, Sch Med, Kyung Hee Univ Hosp Gangdong, Dept Neurol, Seoul, South Korea; [Lee, Jong Yun; Baek, Jang-Hyun] Natl Med Ctr, Dept Neurol, Seoul, South Korea; [Baek, Jang-Hyun] Sungkyunkwan Univ, Sch Med, Kangbuk Samsung Hosp, Dept Neurol, Seoul, South Korea; [Kim, Gyu Sik; Seo, Kwon-Duk] Serv Ilsan Hosp, Natl Hlth Insurance, Dept Neurol, Goyang, South Korea; [Kim, Seo Hyun] Yonsei Univ, Wonju Coll Med, Dept Neurol, Seoul, South Korea; [Song, Tae-Jin] Ewha Womans Univ, Coll Med, Seoul Hosp, Dept Neurol, Seoul, South Korea; [Han, Sang Won; Park, Joong Hyun] Inje Univ, Coll Med, Dept Neurol, Sanggye Paik Hosp, Seoul, South Korea; [Kim, Jinkwon] CHA Univ, CHA Bundang Med Ctr, Dept Neurol, Seongnam, South Korea; [Jung, Yo Han] Changwon Fatima Hosp, Dept Neurol, Gyeongsangnam Do, South Korea; [Cho, Han-Jin] Pusan Natl Univ, Sch Med, Dept Neurol, Busan, South Korea; [Ahn, Seong Hwan] Chosun Univ, Sch Med, Dept Neurol, Gwangju, South Korea; [Lee, Sung Ik; Seo, Kwon-Duk] Wonkwang Univ, Sch Med, Dept Neurol, Sanbon Hosp, Gunpo, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 LIPPINCOTT WILLIAMS & WILKINS
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000181612
- 본문언어 영어
- Published As http://dx.doi.org/10.1161/STROKEAHA.120.032380
초록/요약
Background and Purpose: Patients with acute stroke are often accompanied by comorbidities, such as active cancer. However, adequate treatment guidelines are not available for these patients. The purpose of this study was to evaluate the association between cancer and the outcomes of reperfusion therapy in patients with stroke. Methods: We compared treatment outcomes in patients who underwent reperfusion therapy, using a nationwide reperfusion therapy registry. We divided the patients into 3 groups according to cancer activity: active cancer, nonactive cancer, and without a history of cancer. We investigated reperfusion processes, 24-hour neurological improvement, adverse events, 3-month functional outcome, and 6-month survival and related factors after reperfusion therapy. Results: Among 1338 patients who underwent reperfusion therapy, 62 patients (4.6%) had active cancer, 78 patients (5.8%) had nonactive cancer, and 1198 patients (89.5%) had no history of cancer. Of the enrolled patients, 969 patients received intravenous thrombolysis and 685 patients underwent endovascular treatment (316 patients received combined therapy). Patients with active cancer had more comorbidities and experienced more severe strokes; however, they showed similar 24-hour neurological improvement and adverse events, including cerebral hemorrhage, compared with the other groups. Although the functional outcome at 3 months was poorer than the other groups, 36.4% of patients with active cancer showed functional independence. Additionally, 52.9% of the patients with determined stroke etiology showed functional independence despite active cancer. During the 6-month follow-up, 46.6% of patients with active cancer died, and active cancer was independently associated with poor survival (hazard ratio, 3.973 [95% CI, 2.528-6.245]). Conclusions: In patients with active cancer, reperfusion therapy showed similar adverse events and short-term outcomes to that of other groups. While long-term prognosis was worse in the active cancer group than the nonactive cancer groups, not negligible number of patients had good functional outcomes, especially those with determined stroke mechanisms.
more